Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA, 90073, USA.
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90095, USA.
BMC Health Serv Res. 2024 Oct 4;24(1):1180. doi: 10.1186/s12913-024-11678-6.
Social integration (i.e., reciprocal interactions with peers and community members) is a notable challenge for many homeless-experienced adults with serious mental illness (SMI). In this study, we examine a range of housing services offered to homeless-experienced adults with SMI and identify the impacts of supportive services on participants' social integration outcomes, with the goal of improving services in transitional and permanent housing settings for homeless-experienced adults with SMI.
Through semi-structured interviews with homeless-experienced adults with SMI (n = 30), we examine the impacts of housing and service settings on participants' social integration. Participants received services in a variety of housing settings, including transitional housing with congregate/shared living (n = 10), transitional housing with individual quarters (n = 10), and permanent supportive housing (n = 10).
Participants expressed caution in developing social relationships, as these could pose barriers to recovery goals (e.g., substance use recovery). For many, social integration was secondary to mental and physical health and/or housing stability goals. Individual quarters gave individuals a place of respite and a sense of control regarding when and with whom they socialized. Meeting recovery goals was strongly related to connecting to and receiving a range of supportive services; interviews suggest that proximity to services was critical for engagement in these resources.
Programs serving homeless experienced adults with SMI should seek to understand how individuals conceptualize social integration, and how social relationships can either support or hinder participants' recovery journey.
对于许多有严重精神疾病（SMI）的无家可归经历的成年人来说，社会融合（即与同龄人及社区成员的相互作用）是一个显著的挑战。在这项研究中，我们研究了为有 SMI 的无家可归经历的成年人提供的一系列住房服务，并确定了支持性服务对参与者社会融合结果的影响，目的是改善为有 SMI 的无家可归经历的成年人提供的过渡性和永久性住房服务。
通过对有 SMI 的无家可归经历的成年人（n=30）进行半结构化访谈，我们研究了住房和服务环境对参与者社会融合的影响。参与者在各种住房环境中接受服务，包括集体/共享生活的过渡性住房（n=10）、单人居住的过渡性住房（n=10）和永久性支持性住房（n=10）。
参与者在发展社会关系时表现出谨慎，因为这些关系可能对康复目标（如药物使用康复）构成障碍。对许多人来说，社会融合次于精神和身体健康以及/或住房稳定目标。单人居住的房间为个人提供了一个休息的地方，并使他们在何时以及与谁交往方面获得了一定的控制感。达到康复目标与联系和获得一系列支持性服务密切相关；访谈表明，接近服务对于参与这些资源至关重要。
为有 SMI 的无家可归经历的成年人提供服务的项目应努力了解个人如何理解社会融合，以及社会关系如何支持或阻碍参与者的康复之旅。
